HomeMy WebLinkAboutDrain Layers Permits 929 Foster Street (2) 1600084 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER DRAIN LAYER PERMIT
DATE: 11/30/2016
GIS ID: 33600929 FEE: 60.00
MUNIS APPLICATION# 201601756 EXPIRATION DATE: 12/30/2016
APPLICANT LOCATION
NAME: SKIPS WASTEWATER ..ADDRESS: 929`FOSTER STREET
ADDRESS: 21 COURTNEY DRIVE, OWNER: SIMAO JOAQUIM TR
ELLINGTON, CT 0602 929-FOSTER STREET
- SOUTH WINDSOR,CT 06074
PHONE 860-875-2332 - -
WORK DESCRIPTION: NEW SEWER CONNECTION
THE DRAIN LAYER ASSIGNED TO THIS_PERMIT HAS A VALID LICENSE ISSUED BY'THE STATE AND HEREBY AGREES TO ALL
THE TERMS AND CONDITIONS SET FORTH IN THE ATTACHED`CONDITIONS'. ALL WORK SHALL BE IN ACCORDANCE WITH
THE TOWN OF SOUTH WINDSOR STANDARDS,ALL OSHA REQUIREMENTS,AND THE ATTACHED CONDITIONS.
C 147
ISSUED BY DATE INSPECTED INSPECTED BY
11/30/2016 2:12 PM
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TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO:: 3Y CONTRACTOR: 6LVS,S
LOCATION: �
TYPE OF WORK: NPU)
DATE INSP NEEDED: DATE INSP:
INSPECTED BY: is
WORK IN
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SEPTIC TANK PUMPED,SMASHED, FILLED WITNESSED NO
AS-BUILT:
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S/molloy/foims 2014 Town of South Windsor INPSEMON'REPOU 14
APPLICATION FOR DRAIN LAYER PERMIT
TOWN OF SOUTH WINDSOR
1540 SULLIVAN-AVENUE
PUBLIC WORKS DEPARTMENT
TOWN HALL
SOUTH WINDSOR,CT
FEE$60.00
-Location of proposed wad Lot#
Stmet No. Street Name
-Premises owned by: � Ai A 1-,(S
Name Of Rm1: c�iP�int G,fgST� w/�7E Phone: V60
?S--Z 33 Z
Address of Firm: r _cam R f�1 i2 ,�,�i n/6 nJ
TYPE OF WORK-
Lay House Drainer Repair House Drains.
Lay Main_; Lay Lateral for Commerdai/Indusbial
BuPiding of_acres
Connection will be made with sari 3 PVC,
Existing Water Supply: Public Water_ Well )d
Proposed Start Date_--.Estimated time for completion
ALL WORK TO BE IN ACOORDANCE W1TH TOWN OF SOUTH WINDSOR. D� STANDARDS,
ALL OSHA
UIREMENTS AND COND. Q TRANS ATT
ACHEDTO THE
PERMIT
Permit IS io be issued to the holder of Drain
Layer's License No. _ o z o-)7 2-5--. . Only holders oft -1, P-7. or W-9 licenses
will be issued a permit PERMIT WILL EXPIRE THIRTY(30) DAYS AFTER
DATE OF-ISSUANCE. The undersigned Drain Layer hereby agrees to all the terms
and conditions set forth in the permit and attached ttweto.. Applicant has received
Town Street Excavation Permit No. and/or ConnDOT Permit No.
PLEASE NOTE:
{ CBYD No. TFA'SANITARYSEWER-LA TERAL
IS m7frN75 FEE T OF WELL
ZTNIISrSEAr TESTED
Signed: ``— Print Name: _77
Ucdnsed Drain Layer
Date:_ 70 -/G
Swidar.d ForntftM t XWUCATION FOR DRAIN LAYERS PS M1T.doc
TOWN OF SOUTH WINDSOR
SANITARY SEWER LATERAL FIELD LOCATION
DATE OF CONSTRUCTION: ' 7
BUILDING ADDRESS qZ`t
STREET : ✓'� '/ a>�
SUBDIVISION:
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CONTRA C ORT (PRINT) -� NAME OF CONTRACTOR'S SUPERVISOR (PRINT)
7, 1 A :-)ems- ,�� 4 `' ...
STREET ADDRESS L SIGNATURE
PATE
TOWN STATE ZIP INSPECTED BY TOWN
DATE
TELEPHONE NUMBER
WHITE - TOWN PINK - CONTRACTOR YELLOW - CONSULTING ENGINEER / DEVELOPER